Integrative Care for People With Chronic Illness: Coordination and Expectations

Urgent first, then coordination

A long-term condition can flare or change. New or worsening symptoms need a doctor first, not a supplement or a new practice; in a US emergency, call 911. If you are having thoughts of suicide, the 988 Suicide & Crisis Lifeline is available 24/7/365.[1]

This page is information only. It does not tell anyone to start, stop or change a medicine, and it gives no doses or plans.

What this page is for

People living with diabetes, arthritis, chronic pain, heart or kidney disease, autoimmune conditions and similar illnesses often look for extra support from naturopathic or integrative practitioners. The aim here is coordination: your doctors, your pharmacist and any other practitioner working from the same, complete picture. For condition-specific pages, see diabetes and prediabetes, low back and musculoskeletal pain and autoimmune conditions.

Realistic expectations

NCCIH's pain summary notes that approaches studied for chronic pain, such as acupuncture, meditation, yoga and massage, have good safety records, but that does not mean they are risk-free for everyone.[2] Your health and special circumstances may affect safety.[2]

Evidence differs by use. A large review of individual data found acupuncture more effective than no treatment or sham acupuncture for back or neck pain, and the gap was larger against no treatment than against sham.[2] Yoga's effects are similar to those of other types of exercise, per NCCIH.[2] For dietary supplements in type 2 diabetes, NCCIH says the research is not strong enough to reach definite conclusions.[3]

Proper evidence not found: in the sources we read, we did not find trials showing that whole-system naturopathic care improves long-term outcomes across chronic illnesses in general. Evidence has to be judged one use at a time.

Evidence snapshot

Medicines come first

NCCIH says plainly: do not take a dietary supplement instead of your diabetes medicine, because going without proper treatment raises the risk of serious complications.[3] The same principle applies to any prescribed medicine for a long-term condition. Some supplements can interact with medicines, and some have been linked to kidney disease, a particular concern for people with diabetes.[3] Talk with your prescriber before changing anything. See coordinating complementary and medical care.

Telling your doctors

A systematic review of disclosure across patient groups found that the rate of disclosure of complementary medicine use to medical providers remains low.[4] Reasons patients gave included fear of the provider's disapproval, followed by the provider not asking.[4] Disclosure is how interactions are caught, so tell every clinician. Keep one written list; see medication and supplement review.

Choosing and working with a practitioner

Licensed naturopathic physicians complete graduate-level education at an accredited naturopathic medical school, while traditional naturopaths may train in non-accredited programs and are not eligible for licensing, per NCCIH.[5] Scope of practice varies by state.[5] Questions to ask: what is your training, how will you work with my doctors, what are the risks, and do you sell what you recommend? See questions to ask a naturopath or integrative practitioner.